| NPI | 1154873206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARECE VANTERPOOL Director 347-701-3315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 30987) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |